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Continuous spikes and waves during sleep in children with shunted hydrocephalus
P Veggiotti1, F Beccaria, G Papalia
1Child Neuropsychiatry Division, Neurological Institute C. Mondino Foundation IRCCS, University of Pavia, Italy.
Insights
Children with hydrocephalus shunts show focal EEG abnormalities during sleep, often on the shunt side. Continuous spikes and waves during slow sleep (CSWS) were observed in a third of cases, potentially linked to neuropsychological issues.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Neurosurgery
Background:
- Focal epileptiform abnormalities are known in awake children with ventricular shunts.
- Limited research exists on electroencephalogram (EEG) patterns during sleep in these patients.
Purpose of the Study:
- To investigate EEG patterns in children with hydrocephalus and ventricular shunts during sleep.
- To analyze the prevalence and characteristics of focal abnormalities and continuous spikes and waves during slow sleep (CSWS).
Main Methods:
- Studied 20 children with hydrocephalus treated with shunts in their first year of life.
- Analyzed EEG recordings during sleep, noting focal abnormalities and CSWS.
Main Results:
- All children exhibited focal EEG abnormalities, predominantly ipsilateral to the shunt (95%).
- High-amplitude abnormalities (≥300 mV) were present in 65% of cases.
- Sleep activated abnormalities in all subjects; 33% showed CSWS during slow sleep.
Conclusions:
- Ventricular shunting in hydrocephalic children is associated with significant focal EEG abnormalities during sleep.
- The occurrence of CSWS warrants further investigation regarding its etiology and contribution to neuropsychological deficits in this population.
Abstract:
Focal epileptiform abnormalities in awake children submitted to ventricular shunting are well described in the literature, but there are few reports about EEG patterns during sleep. We studied 20 children affected by hydrocephalus of various aetiology and submitted to shunting during the first year of life. We found focal abnormalities in all the children and in 95% of cases they were on the same side as the shunt; in 65% of cases they had an amplitude of 300 mV or more. During sleep there was activation of abnormalities in all subjects, and in 33% we found continuous spikes and waves during slow sleep (CSWS). We discuss the aetiology of CSWS and its possible role in causing the neuropsychological disturbances of our patients.